Browsing by Author "Aydeniz B."

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    Which swallowing difficulty of food consistency is best predictor for oropharyngeal dysphagia risk in older person?
    (Springer International Publishing, 2019) Umay E.; Eyigor S.; Karahan A.Y.; Keskin D.; Karaca G.; Unlu Z.; Tıkız C.; Vural M.; Aydeniz B.; Alemdaroglu E.; Bilir E.E.; Yalıman A.; Sen E.I.; Akaltun M.S.; Altındag O.; Keles B.Y.; Bilgilisoy M.; Ozcete Z.A.; Demirhan A.; Gundogdu I.
    Aim: Our aim was to investigate which swallowing difficulty of food consistency in older people who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD) risk. Findings: We have found that the eating/drinking difficulty of thick liquids was the highest predictive value with respect to OD risk and the eating difficulty of mixed content food had the highest diagnostic ratio. Message: The present study reports that even in older person who do not go to the hospital with the complaints of swallowing difficulty, the difficulty of swallowing thick liquids and especially the mixed content food should be questioned. Purpose: The present study aimed to investigate which swallowing difficulty of food consistency in participants over 65 years of age who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD). Methods: The cross-sectional and multicenter study was conducted at 12 hospitals including 883 participants aged ≥65 years who were fed orally and who were admitted to the physical medicine and rehabilitation outpatient clinics between September 2017 and December 2018. Demographic characteristics were recorded. Katz Daily Living Activities Index (KDLAI), swallowing-related quality of life scale (Swal-QoL) and 10-item Eating Assessment Tool (EAT-10) were used. The participants were asked the “yes” or “no” questions including swallowing difficulty of various types of food consistency with the face-to-face interview. Results: Participants were divided into two groups as normal swallowing (EAT-10 < 3 group) (n = 639) and OD risk groups (EAT-10 ≥ 3 group) (n = 244) according to the EAT-10 scores. While there was no difference related to number of teeth and KDLAI scores between groups (p = 0.327 and p = 0.221, respectively), the significant difference was found between groups in terms of yes/no questions and Swal-QoL scores (p < 0.05). Receiver operating characteristic analysis revealed that eating difficulty of mixed content food provided maximum sensitivity (99%) and eating/drinking difficulty of thick liquid had maximum specificity (77%). The higher area under curve was in eating/drinking difficulty of thick liquid (0.891), and higher positive likelihood ratio (LR) was eating/drinking difficulty of thick liquid (4.26) as well as lower negative LR was eating difficulty of mixed content food (0.01). The higher diagnostic odds ratio was eating difficulty of mixed content food (367.0), and the higher posttest probability was eating/drinking difficulty of thick liquid (0.211). Conclusion: While eating difficulty of hard solid food is the most common symptom in healthy participants over 65 years of age, the eating difficulty of thick liquids is the highest predictive value related to oropharyngeal dysphagia risk. Also, the eating difficulty of mixed content food had the highest diagnostic ratio. © 2019, European Geriatric Medicine Society.
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    The GUSS test as a good indicator to evaluate dysphagia in healthy older people: a multicenter reliability and validity study
    (Springer International Publishing, 2019) Umay E.; Eyigor S.; Karahan A.Y.; Gezer I.A.; Kurkcu A.; Keskin D.; Karaca G.; Unlu Z.; Tıkız C.; Vural M.; Aydeniz B.; Alemdaroglu E.; Bilir E.E.; Yalıman A.; Sen E.I.; Akaltun M.S.; Altındag O.; Keles B.Y.; Bilgilisoy M.; Ozcete Z.A.; Demirhan A.; Gundogdu I.; Inanir M.; Calik Y.
    Purpose: Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Methods: This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. The study included 1163 participants aged ≥65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity. Results: The age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. The average total GUSS score was 18.57 ± 1.41. The Cronbach’s alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. The cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%. Conclusions: The GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice. © 2019, © 2019, European Geriatric Medicine Society.
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    Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation
    (Springer, 2021) Umay E.; Eyigor S.; Ertekin C.; Unlu Z.; Selcuk B.; Bahat G.; Karahan A.Y.; Secil Y.; Gurcay E.; Kıylioglu N.; Keles B.Y.; Giray E.; Tikiz C.; Gezer I.A.; Yalıman A.; Sen E.I.; Vural M.; Saylam G.; Akaltun M.S.; Sari A.; Alicura S.; Karaahmet F.; Inanir M.; Demirhan A.; Aydeniz B.; Bilgilisoy M.; Yuksel A.; Ozcete Z.A.; Calik Y.; Alemdaroglu E.; Keskin D.; Sahin S.; Oztekin M.F.; Sezgin B.; Karaahmet O.
    Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items). © 2021, Springer Science+Business Media, LLC, part of Springer Nature.
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    Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H
    (Korean Geriatrics Society, 2022) Umay E.; Eyigor S.; Bahat G.; Halil M.; Giray E.; Unsal P.; Unlu Z.; Tikiz C.; Vural M.; Cincin A.T.; Bengisu S.; Gurcay E.; Keseroglu K.; Aydeniz B.; Karaca E.C.; Karaca B.; Yalcin A.; Ozsurekci C.; Seyidoglu D.; Yilmaz O.; Alicura S.; Tokgoz S.; Selcuk B.; Sen E.I.; Karahan A.Y.; Yaliman A.; Ozkok S.; Ilhan B.; Oytun M.G.; Ozturk Z.A.; Akin S.; Yavuz B.; Akaltun M.S.; Sari A.; Inanir M.; Bilgilisoy M.; Çaliskan Z.; Saylam G.; Ozer T.; Eren Y.; Bicakli D.H.; Keskin D.; Ulger Z.; Demirhan A.; Calik Y.; Saka B.; Yigman Z.A.; Ozturk E.A.
    Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oro-pharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the per-spective of different disciplines dealing with older people. Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilita-tion, and follow-up for the management of geriatric dysphagia and also contains detailed com-mentary on these issues. © 2022 by The Korean Geriatrics Society.
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    Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up
    (Springer, 2022) Umay E.; Eyigor S.; Ertekin C.; Unlu Z.; Selcuk B.; Bahat G.; Karahan A.Y.; Secil Y.; Gurcay E.; Kıylioglu N.; Yavuz Keles B.; Giray E.; Tikiz C.; Albayrak Gezer I.; Yalıman A.; Sen E.I.; Vural M.; Saylam G.; Akaltun M.S.; Sari A.; Alicura S.; Karaahmet F.; Inanir M.; Demirhan A.; Aydeniz B.; Bilgilisoy M.; Yuksel A.; Ozcete Z.A.; Calik Y.; Alemdaroglu E.; Keskin D.; Sahin S.; Oztekin M.F.; Sezgin B.; Karaahmet O.; Bengisu S.; Yalcin Gokler T.; Mercimekci S.
    Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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    The caregiver burden of informal caregivers for stroke patients with and without dysphagia: A multi-center, cross-sectional study in Türkiye
    (Turkish Society of Physical Medicine and Rehabilitation, 2023) Giray E.; Eyigör S.; Çalık Y.; Gezer İ.A.; Sarı A.; Umay E.; Akaltun M.S.; Tıkız C.; Ünlü Z.; Vural M.; Aydeniz B.; Karahan A.Y.
    Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients’ swallowing-related quality of life (QoL), and patients’ stroke-specific QoL. Patients and methods: This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient’s swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients’ swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver’s relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments. ©2023 All right reserved by the Turkish Society of Physical Medicine and Rehabilitation.
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    Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey
    (Springer, 2024) Umay E.; Eyigor S.; Demirag K.; Kaymak Karatas G.; Gundogdu I.; Giray E.; Panpalli Ates M.; Gonenli Kocer B.; Gurcay E.; Unlu Z.; Bengisu S.; Karaahmet F.; Bagcier F.; Vural M.; Aydeniz B.; Kullukcu H.; Oztekin F.; Alicura S.; Uz C.; Barmak E.; Uzunkulaoglu A.; Adiguzel E.
    There is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0–10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023.